How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $3,467.37 Median $5,248.07 Typical High $7,943.28 | Facility | None | $3,467.37 | $5,248.07 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $354.81 Typical High $812.83 | Professional | None | $138.04 | $354.81 | $812.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $27,542.29 Median $27,542.29 Typical High $37,153.52 | Facility | None | $27,542.29 | $27,542.29 | $37,153.52 |
Anthem BCBS Setting Professional Modifier None Typical Low $190.55 Median $426.58 Typical High $1,174.90 | Professional | None | $190.55 | $426.58 | $1,174.90 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $446.68 Typical High $1,071.52 | Professional | None | $177.83 | $446.68 | $1,071.52 |
ConnectiCare Setting Professional Modifier None Typical Low $660.69 Median $851.14 Typical High $954.99 | Professional | None | $660.69 | $851.14 | $954.99 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $3,890.45 Typical High $7,079.46 | Facility | None | $1,318.26 | $3,890.45 | $7,079.46 |
United Setting Professional Modifier None Typical Low $138.04 Median $467.74 Typical High $1,548.82 | Professional | None | $138.04 | $467.74 | $1,548.82 |
5 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $67.61 Median $177.83 Typical High $407.38 | Professional | 52 · Reduced service | $67.61 | $177.83 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $70.79 Typical High $162.18 | Professional | 53 · Discontinued | $27.54 | $70.79 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $269.15 Typical High $602.56 | Professional | 54 · Surgery only | $102.33 | $269.15 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $53.70 Typical High $120.23 | Professional | 55 · Aftercare only | $20.42 | $53.70 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $35.48 Typical High $81.28 | Professional | 56 · Pre-op care only | $13.49 | $35.48 | $81.28 |
Where Connecticut sits
The same service costs 4.0 times more in Wisconsin than in Maryland. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Connecticut· 28th of 51
$457
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.